Cross-Sectional Serosurvey of Companion Animals Housed with SARS-CoV-2–Infected Owners,Italy

We conducted a serologic survey among dogs and cats in Italy to detect antibodies against severe acute respiratory syndrome virus 2 (SARS-CoV-2). We found that SARS-CoV-2 seroprevalence was higher among cats (16.2%) than dogs (2.3%). In addition, seroprevalence was higher among animals living in close contact with SARS-CoV-2–positive owners.     

Amikacin and ceftazidime as empirical antibiotic therapy in severely neutropenic patients: analysis of prognostic factors

This study aimed to evaluate the efficacy of amikacine and ceftazidime as an empirical antibiotic therapy for neutropenic patients affected by haematological neoplasms and to investigate the presence of prognostic features suggesting a poor outcome with this antibiotic combination at the onset of infection. This could allow the identification of subgroups of patients with a low rate of response to amikacin/ceftazidime therapy; in these patients different initial empirical therapy may be indicated. The study population comprised 166 severely neutropenic (absolute neutrophil count below 500/l) oncohaematological patients with fever or clinical signs of infection. Multivariate analysis confirmed four negative prognostic factors: 3 or more days of hospitalization at the onset of an infectious episode, a diagnosis of acute myeloid leukaemia, a haematological disease status different from complete remission, the presence of pneumonia. Depending on how many factors are present, cases can be stratified into three groups, of significantly different prognosis: favourable (0 or 1 factor) 76% success; intermediate (2 factors) 52% success; unfavourable (3 or 4 factors) 19% success. At the onset of an infectious episode a subgroup of patients with a very low response rate to empirical amikacin/ceftazidime antibiotic therapy is identifiable, for whom a different therapy is indicated. Because of the high rate of proven or probable fungal infections in this group, the immediate administration of a systemic antifungal therapy, in addition to antibacterial agents, could be considered in these high-risk patients. Studies should be specifically addressed to evaluating a stratification of empirical antibiotic therapy according to risk factors present at the onset of infection.     

Alpha1 acid glycoprotein binds to imatinib (STI571) and substantially alters its pharmacokinetics in chronic myeloid leukemia patients.

PURPOSE: Imatinib (Glivec) is a potent inhibitor of bcr/abl, an oncogenic fusion protein that causes chronic myelogenous leukemia (CML). alpha1 acid glycoprotein (AGP) binds to imatinib with high affinity and inhibits imatinib activity in vitro and in vivo in an animal model. A pharmacokinetics analysis of imatinib was undertaken in CML patients. EXPERIMENTAL DESIGN: Imatinib plasma concentrations were measured in 19 CML patients treated with imatinib (400 or 600 mg/day). Five patients received a concomitant short-term course of clindamycin (CLI). RESULTS: A positive correlation between AGP and imatinib plasma levels was observed. CLI administration decreased imatinib plasma concentrations, evaluated as area under the curve (AUC) and peak concentrations (C(max)). The effects of a bolus of CLI was studied in three patients on imatinib 23 h after the last imatinib dose. Within 5-10 min in three of three cases, CLI caused a decrease in imatinib plasma concentrations of 2.6-, 2.7-, and 4.7-fold, respectively. In vitro experiments using fresh blasts from CML patients showed that AGP, at concentrations observed in the patients, decreased imatinib intracellular concentrations up to 10 times and blocked imatinib activity. The incubation with CLI restored imatinib intracellular concentrations and biological activity. CONCLUSION: AGP exerts significant effects of the pharmacokinetics, plasma concentrations, and intracellular distribution of imatinib in CML patients; these data indicate that plasma imatinib levels represent unreliable indicators of the cellular concentrations of this molecule.     

Quantifying the Effect of Abdominal Body Wall on In Situ Peak Rarefaction Pressure During Diagnostic Ultrasound Imaging

In this study, 3-D non-linear ultrasound simulations and experimental measurements were used to estimate the range of in situ pressures that can occur during transcutaneous abdominal imaging and to identify the sources of error when estimating in situ peak rarefaction pressures (PRPs) using linear derating, as specified by the mechanical index (MI) guideline. Using simulations, it was found that, for a large transmit aperture (F/1.5), MI consistently over-estimated in situ PRP by 20%–48% primarily owing to phase aberration. For a medium transmit aperture (F/3), the MI accurately estimated the in situ PRP to within 8%. For a small transmit aperture (F/5), MI consistently underestimated the in situ PRP by 32%–50%, with peak locations occurring 1–2 cm before the focal depth, often within the body wall itself. The large variability across body wall samples and focal configurations demonstrates the limitations of the simplified linear derating scheme. The results suggest that patient-specific in situ PRP estimation would allow for increases in transmit pressures, particularly for tightly focused beams, to improve diagnostic image quality while ensuring patient safety.     

Impact of prior statin use on clinical outcomes in COVID-19 patients: data from tertiary referral hospitals during COVID-19 pandemic in Italy

BackgroundEpidemiological evidence suggests that anti-inflammatory and immunomodulatory properties of statins may reduce the risk of infections and infection-related complications.ObjectiveWe aimed to assess the impact of prior statin use on coronavirus disease (COVID-19) severity and mortality.MethodsIn this observational multicenter study, consecutive patients hospitalized for COVID-19 were enrolled. In-hospital mortality and severity of COVID-19 assessed with National Early Warning Score (NEWS) were deemed primary and secondary outcomes, respectively. Propensity score (PS) matching was used to obtain balanced cohorts.ResultsAmong 842 patients enrolled, 179 (21%) were treated with statins before admission. Statin patients showed more comorbidities and more severe COVID-19 (NEWS 4 [IQR 2–6] vs 3 [IQR 2–5], p < 0.001). Despite having similar rates of intensive care unit admission, noninvasive ventilation, and mechanical ventilation, statin users appeared to show higher mortality rates. After balancing pre-existing relevant clinical conditions that could affect COVID-19 prognosis with PS matching, statin therapy confirmed its association with a more severe disease (NEWS ≥5 61% vs. 48%, p = 0.025) but not with in-hospital mortality (26% vs. 28%, p = 0.185). At univariate logistic regression analysis, statin use was confirmed not to be associated with mortality (OR 0.901; 95% CI: 0.537 to 1.51; p = 0.692) and to be associated with a more severe disease (NEWS≥5 OR 1.7; 95% CI 1.067–2.71; p = 0.026).ConclusionsOur results did not confirm the supposed favorable effects of statin therapy on COVID-19 outcomes. Conversely, they suggest that statin use should be considered as a proxy of underlying comorbidities, which indeed expose to increased risks of more severe COVID-19.     

Use of N-Butyl-2-Cyanoacrylate (Glubran2?) in Fractures of Orbital-Maxillo-Zygomatic Complex

Introduction

Fractures of the orbital-maxillo-zygomatic complex are among the most common fractures affecting the facial skeleton. Goal of surgical treatment is the realignment of fracture lines for a complete functional and aesthetic rehabilitation.

Materials and Methods

From January 2008 to January 2011 in the Department of Maxillofacial Surgery of Complesso Integrato Columbus of the Università Cattolica del Sacro Cuore in Rome, 25 patients, affected by comminute fractures of the anterior wall of the maxillary sinus associated with fractures of the orbital-maxillary complex were selected. The synthesis of the larger fracture fragments was performed by plates and screws (1.5 mm) while a biocompatible glue (N-Butyl-2-Cyanoacrylate–Glubran2^®) was applied to treat the comminute fractures of the anterior wall of the maxillary sinus.

Results and Conclusion

The aim of our article is to report our experience and a review of the literature on application of–Butyl-2-Cyanoacrylate for treatment of comminute fractures of the anterior wall of the maxillary sinus. According to the results achieved in our study the N-Butyl-2-Cyanoacrylate can be indicated to treat comminuted fractures of the anterior wall of the maxillary sinus which could not easily be treated with internal rigid fixation.     

Comparison between biparietal bipolar and uniparietal bipolar radio frequency ablation techniques in a simultaneous procedural setting

Purpose

To make an in vitro evaluation of the lesion size and depth produced in two different sets of radio frequency energy bipolar delivery: simultaneous biparietal bipolar (SBB) and simultaneous uniparietal bipolar (SUB).

Methods

Two separate prototypes have been built for our purpose: one to be used in SBB mode and the other to be used SUB mode. Forty left atrium samples were taken from the hearts of freshly slaughtered pigs. They were ablated into a simulator ABLABOX, where blood flow, temperature, and contact force were controlled. After being sliced into a cryotome, the samples were digitalized by a flatbed scanner, and the images were analyzed by a computer morphometric software.

Results

Transmural lesions were achieved in 18/20 samples (90%) in SBB, while SUB showed transmurality in 9/20 samples (45%). Overall maximum diameter (D_MAX) resulted larger in SUB than in SBB (2.43?±?0.30 mm, 1.62?±?0.14 mm, respectively; p?<?0.05): Moreover, maximum epicardial and endocardial diameters (D_EPI and D_ENDO, respectively) were wider in SUB group than SBB group (2.28?±?0.30 mm, 2.26?±?0.40 and 1.60?±?0.14 mm, 1.59?±?0.15 mm, respectively; p?<?0.05). We observed the same tendency in lesion depth: The total area and volume (A_TOT and V_TOT) were broader in SUB group than in SBB one (581.01?±?65.38 mm/mm², 58.10?±?6.53 mm/mm³ and 521.97?±?73.05 mm/mm², 52.19?±?7.30 mm/mm³. respectively; p?<?0.05).

Conclusions

In contrast with the smaller lesion sizes, the biparietal bipolar group showed a higher transmurality rate. These findings may suggest a better drive of the energy flow when compared with SUB lesions.

     

The echo chamber effect on social media

Social media may limit the exposure to diverse perspectives and favor the formation of groups of like-minded users framing and reinforcing a shared narrative, that is, echo chambers. However, the interaction paradigms among users and feed algorithms greatly vary across social media platforms. This paper explores the key differences between the main social media platforms and how they are likely to influence information spreading and echo chambers’ formation. We perform a comparative analysis of more than 100 million pieces of content concerning several controversial topics (e.g., gun control, vaccination, abortion) from Gab, Facebook, Reddit, and Twitter. We quantify echo chambers over social media by two main ingredients: 1) homophily in the interaction networks and 2) bias in the information diffusion toward like-minded peers. Our results show that the aggregation of users in homophilic clusters dominate online interactions on Facebook and Twitter. We conclude the paper by directly comparing news consumption on Facebook and Reddit, finding higher segregation on Facebook.

Social media radically changed the mechanism by which we access information and form our opinions (1–5). We need to understand how people seek or avoid information and how those decisions affect their behavior (6), especially when the news cycle—dominated by the disintermediated diffusion of information—alters the way information is consumed and reported on. A recent study (7) limited to Twitter claimed that fake news travels faster than real news. However, a multitude of factors affects information spreading on social media platforms. Online polarization, for instance, may foster misinformation spreading (1, 8). Our attention span remains limited (9, 10), and feed algorithms might limit our selection process by suggesting contents similar to the ones we are usually exposed to (11–13). Furthermore, users show a tendency to favor information adhering to their beliefs and join groups formed around a shared narrative, that is, echo chambers (1, 14–18). We can broadly define echo chambers as environments in which the opinion, political leaning, or belief of users about a topic gets reinforced due to repeated interactions with peers or sources having similar tendencies and attitudes. Selective exposure (19) and confirmation bias (20) (i.e., the tendency to seek information adhering to preexisting opinions) may explain the emergence of echo chambers on social media (1, 17, 21, 22).According to group polarization theory (23), an echo chamber can act as a mechanism to reinforce an existing opinion within a group and, as a result, move the entire group toward more extreme positions. Echo chambers have been shown to exist in various forms of online media such as blogs (24), forums (25), and social media sites (26–28). Some studies point out echo chambers as an emerging effect of human tendencies, such as selective exposure, contagion, and group polarization (13, 23, 29–31). However, recently, the effects and the very existence of echo chambers have been questioned (2, 27, 32). This issue is also fueled by the scarcity of comparative studies on social media, especially concerning news consumption (33). In this context, the debate around echo chambers is fundamental to understanding social media’s influence on information consumption and public opinion formation. In this paper, we explore the key differences between social media platforms and how they are likely to influence the formation of echo chambers or not. As recently shown in the case of selective exposure to news outlets, studies considering multiple platforms can offer a fresh view on long-debated problems (34). Different platforms offer different interaction paradigms to users, ranging from retweets and mentions on Twitter to likes and comments in groups on Facebook, thus triggering very different social dynamics (35). We introduce an operational definition of echo chambers to provide a common methodological ground to explore how different platforms influence their formation. In particular, we operationalize the two common elements that characterize echo chambers into observables that can be quantified and empirically measured, namely, 1) the inference of the user’s leaning for a specific topic (e.g., politics, vaccines) and 2) the structure of their social interactions on the platform. Then, we use these elements to assess echo chambers’ presence by looking at two different aspects: 1) homophily in interactions concerning a specific topic and 2) bias in information diffusion from like-minded sources. We focus our analysis on multiple platforms: Facebook, Twitter, Reddit, and Gab. These platforms present similar features and functionalities (e.g., they all allow social feedback actions such as likes or upvotes) and design (e.g., Gab is similar to Twitter) but also distinctive features (e.g., Reddit is structured in communities of interest called subreddits). Reddit is one of the most visited websites worldwide (https://www.alexa.com/siteinfo/reddit.com) and is organized as a forum to collect discussions on a wide range of topics, from politics to emotional support. Gab claims to be a social platform aimed at protecting freedom of speech. However, low moderation and regulation on content has resulted in widespread hate speech. For these reasons, it has been repeatedly suspended by its service provider, and its mobile app has been banned from both App and Play stores (36). Overall, we account for the interactions of more than 1 million active users on the four platforms, for a total of more than 100 million unique pieces of content, including posts and social interactions. Our analysis shows that platforms organized around social networks and news feed algorithms, such as Facebook and Twitter, favor the emergence of echo chambers.We conclude the paper by directly comparing news consumption on Facebook and Reddit, finding higher segregation on Facebook than on Reddit.